Nursing at SaintA

For most of my career, behavioral health has been the focus of my RN practice. I have extensive experience with in-patient units, community mental health clinics and day treatment programs. But I had not worked in a residential facility prior to working at SaintA. The first day here, I knew that this was going to be a special place to work!

The nursing department was quite new at that time, (about a month old), and was just starting to develop. Our department now consists of one RN and three LPNs. Although we are not present 24 hours a day, there is a nurse on duty every day between 8 a.m.-10 p.m. If a resident requires medical care when a nurse is not in, SaintA has policies in place to ensure that he receives it.

Our regular duties include medication management/distribution, patient teaching and thorough documentation of the boys’ health and nursing interventions. We also monitor growth and development and ensure that the boys get yearly physicals and eye, hearing and dental appointments mandated by the state.

A nursing presence such as ours is quite uncommon in a residential facility. Because of it, we are able to accept children who may not be accepted into other facilities because of their medical conditions. Having nurses here allows the boys to function within our daily structure despite their challenges. And having a medical team also helps ease the anxiety of our non-medical staff, knowing that nurses are monitoring medical issues and that they can contact us with questions.

Here at SaintA, we believe in trauma informed care and have identified Seven Essential Ingredients to understanding and achieving it. They are prevalence, impact, perspective shift, regulation, relationship, reason to be, and caregiver capacity. One of the things I really like about working at SaintA is that, because the boys live here for a period of time, relationships develop. When one of the nurses is not at work, the boys always will ask whether she is OK or where she might be.

When one of the residents I’ll call Tom was admitted, he immediately started to ask how he could help me when I arrived on his unit to give medications. I told him I always need a pitcher of water. He got a pitcher in the kitchen and returned to the medication cart still eager to help. As I thanked him, I noticed that his eye contact was only fair, that his speech was soft, and that he did not offer much more communication. Over time, he continued to ask to help me and eventually took complete ownership of the task. As soon as he would see me, he immediately went in to “I’m helping the nurse” mode. As this continued, I noticed that his eye contact had improved, his speech was more confident, and he even stood taller. To say that Tom had challenges with his behavior would be an understatement, but this simple task seemed to create a purpose for him.

Terry was newly admitted to SaintA when I arrived to pass medications. He was yelling loudly and throwing things. After he had regained his composure, I asked him why he was yelling and if I could help. “I’m mad because all of my stuff was packed up and I had to come here. Nobody wants me!” he said. After more questions, he said he didn’t want to live at SaintA forever. Once I assured him that this definitely was not the case, he was able to smile and say, “Thanks Nurse Jean!” He was always comfortable asking to talk to me after that, and he would seek me out when he needed to do so. Of course, Terry did eventually leave SaintA, and my hope is that his new life suits him well.

As a nurse I am always looking for opportunities to teach. I like to see the faces of the boys when they are able to experience new things. When obtaining monthly vital signs one day, Tim appeared to be upset after I told him his height. Let’s just say that Tim was vertically challenged and hadn’t increased in height in a few months. I decided that I was going to try something different. Not wanting to send him back to his unit feeling sad about something that he has no control over, I let him know that, despite his height, he is a unique person. I asked him if he had ever heard his heartbeat, and he said no. When I had him listen to his heart with a stethoscope, his eyes got really big and he smiled from ear to ear. After a few minutes of listening, he was ready to go back to his unit. I told him that nobody else has the exact same heartbeat as his; it was his and his alone. To be able to send him back to his unit smiling not only made his day, it made mine, too. The next month when I was recording vital signs, he wanted to listen to his heartbeat again. No problem. Oh, and it didn’t hurt that he grew half an inch taller!

I’ve wanted to be a nurse since age 4. I’m always looking for opportunities to help, heal and teach. Working here provides all these opportunities in many different ways. Whether it’s a pitcher of water, listening to a child’s fears, or listening to your own heartbeat for the first time, the opportunity to guide these young residents through adverse experiences in their lives and give them a chance of a better future is quite rewarding.